Cerebral Hemodynamics and Cognitive Function in Cirrhotic Patients with Hepatic Encephalopathy

Yuqing Zhou; Qian Dong; Rong Zhang; Shunfeng Zhou; Linqiang Li; Keran Cheng; Rui Kong; Qiang Yu; Shizan Xu; Jingjing Li; Sainan Li; Jiao Feng; Liwei Wu; Tong Liu; Xiya Lu; Kan Chen; Yujing Xia; Jie Lu; Yingqun Zhou; Chuanyong Guo

doi:10.1155/2016/8485032

Cerebral Hemodynamics and Cognitive Function in Cirrhotic Patients with Hepatic Encephalopathy

Gastroenterol Res Pract. 2016:2016:8485032. doi: 10.1155/2016/8485032. Epub 2016 Dec 21.

Authors

Yuqing Zhou¹, Qian Dong², Rong Zhang³, Shunfeng Zhou¹, Linqiang Li¹, Keran Cheng¹, Rui Kong¹, Qiang Yu³, Shizan Xu³, Jingjing Li⁴, Sainan Li⁴, Jiao Feng⁴, Liwei Wu⁴, Tong Liu⁴, Xiya Lu⁴, Kan Chen⁴, Yujing Xia⁴, Jie Lu⁴, Yingqun Zhou⁴, Chuanyong Guo⁴

Affiliations

¹ Department of Gastroenterology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China; The School of Medicine of Soochow University, Suzhou 215006, China.
² The Shanghai Tenth Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai 200072, China.
³ Department of Gastroenterology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China; The Shanghai Tenth Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai 200072, China.
⁴ Department of Gastroenterology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China.

Abstract

Aims. To investigate cerebral hemodynamics in cirrhotic patients with HE and to observe effects of treatment in cerebral hemodynamics and correlations among ammonia, cerebral hemodynamics, and cognitive function. Methods. There were four groups: healthy controls (group 1), cirrhosis without HE (group 2), cirrhosis with MHE (group 3), and cirrhosis with OHE (group 4). Ammonia and cerebral hemodynamics (by TCD) were assessed. Patients in group 3 were subsequently randomized to two subgroups: the control (group A) and the treated (group B, treated with lactulose for two months), and they were retested for ammonia and TCD after treatment.

Results: Ammonia, V_m , V_d , PI, and RI were statistically different before treatment, and ammonia, PI, and RI levels paralleled the severity of HE (P < 0.05). In group B, V_d increased and ammonia, PI, and RI declined following treatment (P < 0.05), while there were no differences in group A (P > 0.05). Correlations were found between ammonia and V_d , PI, RI, NCT-A, and DST and also found between V_d , PI, RI, and NCT-A and DST (P < 0.05). Conclusions. This study revealed that cerebral hemodynamics were related to the severity of HE and cerebral autoregulation was impaired. There were tight correlations among ammonia, cerebral hemodynamics, and cognitive function, and, following treatment, cerebral hemodynamics improved.